Generally, joint surgery, such as implantation of prostheses, includes cutting of bone and cartilage tissue. For example, total knee replacement (TKR) involves surgical resection of the entire or the majority of the articular surface of one or more bones. With these procedures, the marrow space is reamed in order to fit the stem of the prosthesis. Less invasive joint arthoplasties, such as those described in U.S. Patent Publication No. 20030216669 also will generally involve some shaping of the cartilage and/or bone in the target joint.
Various tools are currently available for cutting cartilage and bone. Commercially available osteotomes typically have a single straight or curved cutting surface. See, e.g., HOKE, HIBBS, and LAMBOTTE osteomes available from Miltex, Inc. (York, Pa.); tools available from Biomet, Inc (Warsaw, Ind.); U.S. Pat. No. 4,586,496 to Keller; and U.S. Pat. No. 4,601,290 to Effron et al.
Surgical tools having a cylindrical cutting surface have also been described. See, e.g., U.S. Pat. No. 4,203,444 to Bonnell and U.S. Pat. No. 6,679,917. However, cylindrical configuration of the rotating cutting edges typically creates a depression with a curved, concave surface, as opposed to a box-like depression with more or less flattened sides. As much as the surgeon may attempt to match the equator of the concavity, removal of additional tissue always leaves behind a ridge or protrusion on the treated surface. Such protrusions are particularly disadvantageous in joint surgery where jagged or protruding surfaces on cartilage or bone can inhibit free joint movement and lead to pain and inflammation after surgery.
Thus, there remains a need for surgical cutting devices that readily create a cartilage or bone surface that is more or less normal in topography for the joint or region being treated after desired tissue is removed, thereby avoiding the production of ridges, protuberances or odd shaping that may hinder or make joint movement painful after surgery. There is a further need for a surgical cutting device that permits more efficient cutting and sculpting of tissue in order to reduce the duration of surgery.